Meeting Your Calcium Needs with GI Disorders

Meeting Your Calcium Needs with GI Disorders

Published on Friday, February 11, 2022 by Allison Koch

If you have an issue with your GI tract…Listen up.

And by issue, I am talking about acid reflux, GERD, IBS, Inflammatory Bowel Disease (IBD) and everything else that can impact your small intestine since that is where your calcium starts its journey in the body. In the small intestine, calcium is taken through the blood to your bones and other tissues but if there are issues preventing calcium from being utilized effectively, there can be some potentially serious complications.

One of these serious complications includes the development of osteoporosis.

Here’s the thing with osteoporosis- it’s not just something that happens to elderly people. Osteoporosis is when your body is unable to keep up with the creation of new bone tissue to compensate for the loss of old bone tissue. When the bones become weakened, they are at a higher risk of fracture. Most fractures with osteoporosis include the hips, wrists, or spine.

There have long been discussions of the role of proton pump inhibitors (PPIs) and calcium absorption in reflux and GERD sufferers, which has led to further investigation of the role of PPI therapy and osteoporotic fracture risk (Curr Gastroenterol Rep, 2012). For IBS sufferers, an increased risk of osteoporosis has been well documented when compared to those who do not suffer from IBS (J Clin Med, 2021). And this is consistent in individuals with IBD, with additional investigative studies showing that the dietary intake of calcium is also low in these groups when compared to healthy individuals. One study discussed that the inadequate calcium intake was mainly a result of dietary restriction due to self-reported lactose intolerance (J Crohns Colitis, 2014). 

Lactose intolerance should never be a limitation to consuming adequate calcium. There are many non-dairy sources of calcium to fit into your daily nutrition routine. Here are some examples of calcium sources from non-dairy foods and beverages (find more examples by visiting the Dietary Guidelines 2020-2025 Food Sources of Calcium) :


Calcium (Mg)

Unsweetened Almond Milk- 1 Cup

442 mg

Tofu, Raw with Calcium Sulfate- ½ Cup

434 mg

100% Grapefruit Juice, Fortified- 1 Cup

350 mg

100% Orange Juice, Fortified- 1 Cup

349 mg

Sardines, Canned- 3 ounces

325 mg

Unsweetened Rice Milk- 1 Cup

283 mg

Collard Greens, Cooked- 1 Cup

268 mg

Spinach, Cooked- 1 Cup

245 mg

Bok Choy, Cooked- 1 Cup

185 mg

Kale, Cooked- 1 Cup

177 mg

When evaluating your calcium intake, it is important to know what the Recommended Dietary Allowance (RDA) and the Tolerable Upper Intake Levels (UL) are for calcium. Additionally, spacing your calcium intake throughout the day will help with absorption (the body can absorb around 500 mg of calcium at one time), as well as making sure you are getting enough Vitamin D- which is also required for calcium absorption (20 minutes of sunshine usually does the trick!).

Calcium recommendations for individuals are displayed in milligrams (mg):

  • The Recommended Dietary Allowance (RDA) is the average daily level of intake sufficient to meet the nutrient requirements of nearly all healthy individuals (97-98%).
  • The Tolerable Upper Intake Level (UL) is the maximum daily intake- unlikely to cause adverse health effects.






9-18 years

1300 mg

3000 mg

1300 mg

3000 mg

19-50 years

1000 mg

2500 mg

1000 mg

2500 mg

51-70 years

1000 mg

2000 mg

1200 mg

2000 mg

≥ 70+ years

1200 mg

2000 mg

1200 mg

2000 mg

Here are some great examples of calcium sources from the dairy group if you have no problems with lactose intolerance. Check out the sources of calcium on this fact sheet for more sources: 

  • 1 Cup of Plain, Low Fat Yogurt- 415 mg
  • 1.5 ounces of Part-Skim Mozzarella Cheese- 333 mg
  • 1 Cup of Nonfat Milk- 299 mg

If you are having difficulty meeting your calcium needs or have questions about potential nutrient-medication interactions related to calcium, please speak with your medical provider.

Some plant-based milk alternatives to help you meet your calcium needs:

Unsweetened Almond Milk (32 oz, Pack of 6)

Unsweetened Flax Milk (32 oz, Pack of 6)

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